CommercialPrior AuthHigh impact
MPC November 2025
Blue Cross Blue Shield of Nebraska·NE · Cardiology, Radiology, Pulmonology +5 more·Medical Policy
Effective date
Feb 15, 2026
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska updated six medical policies effective February 15, 2026, adding new prior authorization requirements for CTA and bone density tests, expanding coverage criteria for amniotic membrane treatments and bioengineered skin substitutes, and updating respiratory device and sleep apnea surgery criteria.
Action Required
By February 15, 2026: Billing team must update system to require prior authorization for all CTA procedures and bone mineral density measurements (codes 77081, 77078, 77085, 77086, 76777, 78350, 78351, 77089-77092). Update encounter forms to alert providers about new prior auth requirements. Remove prior auth requirement for amniotic membrane treatments. Update documentation templates to reflect new coverage criteria for hypoglossal nerve stimulation and respiratory devices. Claims submitted without required prior authorization will be denied.